<?php
    $options = array();
    $options['action'] = $this->url( array('controller'=>'index', 'action'=>'preregnewcase') );
    $options['branch'] = $this->branch;
    
	$form = new PreregCaseForm($options);
	$form->populate( $this->preregcase );

	echo $this->home['name']."<br>";
	echo $this->home['addr1']."<br>";
	echo $this->home['city'].", ".$this->home['state']."<p>";
		
	echo $form;
?>